OSH Code · Form XXVI

Form XXVI — Application for Composition of Offence

Form XXVI of the OSH & Working Conditions (Central) Rules 2026, prescribed under Rule 182(1).

Rule: Rule 182(1) · Signed by: Occupier

What the form records

Name of applicant
Father's / Spouse name
Address of the applicant
Name of establishment
Particulars of the offence
Section of the Code under which the offence is committed
Maximum fine provided for the offence under the Code
Whether prosecution against the applicant is pending or not
Whether the offence is a first offence or whether the applicant has committed any other offence prior to the offence. If yes, then, full details of such prior offence
Any other information which the applicant desires to provide
Applicant (Name and signature)
Dated

Part of the Seventh Schedule to the OSH & Working Conditions (Central) Rules 2026. View the official form layout in the gazette, or open the OSH Code forms in MedFactory.

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